Wednesday, January 27, 2010

More on Pacing and CFS

http://www.rehab.research.va.gov/jour/09/46/7/contents.html  

JRRD at a Glance

Volume 46 Number 7, 2009
Pages 985  - 996
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Can pacing self-management alter physical behavior and symptom severity in
chronic fatigue syndrome? A case series

Jo Nijs, PhD, PT; Inge van Eupen, OT; Jo Vandecauter, PT; Els Augustinus,
PT; Geerte Bleyen, OT; Greta Moorkens, PhD, MD; Mira Meeus, PhD, PT

Chronic fatigue syndrome (CFS) is a serious illness with high disability
levels. This study examined whether physical behavior and health status of
patients with CFS improve in response to an activity self-management
program. Activity self-management for people with CFS involves encouraging
the patients to pace their activities and respect their physical and mental
limitations. It involves encouraging the patient to achieve an appropriate
balance between activity and rest in order to avoid exacerbating symptoms.
Seven patients with CFS were observed for 7 consecutive days prior to and
following the activity self-management program. Following treatment,
patients experienced less severe symptoms, improved daily functioning, and
displayed different physical behavior.


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http://www.rehab.research.va.gov/jour/09/46/7/absnijs.html  

Abstract - Can pacing self-management alter physical behavior and symptom
severity in chronic fatigue syndrome? A case series

Jo Nijs, PhD, PT;1-3* Inge van Eupen, OT;4 Jo Vandecauter, PT;1 Els
Augustinus, PT;1 Geerte Bleyen, OT;4 Greta Moorkens, PhD, MD;5-6 Mira Meeus,
PhD, PT1-2

1Division of Musculoskeletal Physiotherapy, Department of Health Care
Sciences, Artesis University College Antwerp, Antwerp, Belgium; 2Department
of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije
Universiteit Brussel, Brussels, Belgium; 3Department of Physical Medicine
and Physiotherapy, University Hospital Brussels, Brussels, Belgium;
4Division of Occupational Therapy, Department of Health Care Sciences,
Artesis University College Antwerp, Antwerp, Belgium; 5Department of
Internal Medicine, University Hospital Antwerp, Antwerp, Belgium; 6Faculty
of Medicine, University of Antwerp, Antwerp, Belgium

Abstract - Given the lack of evidence in support of pacing self-management
for patients with chronic fatigue syndrome (CFS), we examined whether
physical behavior and health status of patients with CFS would improve in
response to a pacing self-management program. We performed an observational
study of pacing self-management in seven CFS patients using a single-case
study design. Stages A1 and A2 (7-day assessment periods) of the A1-B-A2
design corresponded to the baseline and posttreatment measurements of
physical behavior (real-time activity monitoring) and health status
(self-reported measures), respectively. Stage B (3 weeks of treatment)
consisted of three individual treatment sessions of pacing self-management.
When comparing pre- versus posttreatment data, we found that the patients'
ability to perform daily activities and the severity of their symptom
complexes were improved (p = 0.043). Concentration difficulties, mood
swings, muscle weakness, and intolerance to bright light improved as well. A
statistically significant decrease in the mean time spent doing light
activity (<3 metabolic equivalents) was observed, but a change in the way
physical activity was spread throughout the day was not. We found that 3
weeks of pacing self-management was accompanied by a modest improvement in
symptom severity and daily functioning. The outcome of the present study
calls for a randomized controlled clinical trial to examine the
effectiveness of pacing self-management for people with CFS.

Key words: activity, activity peak, behavior, CFS, chronic fatigue, pacing,
rehabilitation, self-management, syndrome, therapy.

Free full text in html at:
http://www.rehab.research.va.gov/jour/09/46/7/nijs.html  

Free full text in pdf form at:
http://www.rehab.research.va.gov/jour/09/46/7/pdf/nijs.pdf  


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JRRD is an open-access, international peer-reviewed rehabilitation journal
published in English, with 10 regular issues published per year. The journal
has been a leading research journal in the field of rehabilitation medicine
and technology for 45 years. JRRD publishes original research articles,
clinical studies, topical reviews, and editorials from U.S. and
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publishes both multi- and single-topic issues.

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